“Common Knowledge” Exception Insufficent to Save MedMal Case
In Unitta Sue Newman v. Guardian Healthcare Providers, Inc., the Tennessee Court of Appeals addressed the “common knowledge” exception – an exception to the requirement of expert testimony in certain medical malpractice actions. Spoiler alert: the exception almost never applies…
The plaintiff in the case is the surviving widow of Billy Joe Newman who was attacked and killed by another patient at the Middle Tennessee Mental Health Institute (MTMHI). She filed suit against various entities related to the care provided at MTMHI. MTMHI is a mental health facility. Mr. Newman was hospitalized there, along with his assailant, Kevin Beazley.
The wrongful death complaint alleged claims of negligence. Specifically, the complaint alleged that the employees of the defendants knew Mr. Beazley was a violent person who had a tendency toward unprovoked violence and whose acts in this instance were foreseeable.
The defendants moved to dismiss the complaint, arguing that the plaintiff failed to comply with the pre-suit notice requirement (Tenn. Code Ann. § 29-26-121) and the certificate of good faith requirement (Tenn. Code Ann. §29-26-122) required for health care liability actions. The trial court agreed that the complaint alleged claims that were related to the rendition of medical treatment by a medical professional such that compliance with all provisions of the health care liability act was required. The trial court, therefore, dismissed the lawsuit with prejudice. Plaintiff appealed.
On appeal, plaintiff did not dispute that the complaint fell within the ambit of the Health Care Liability Act. Plaintiff also did not dispute that she failed to file the required pre-suit notice. The result of failing to send a pre-suit notice was only a dismissal without prejudice, so plaintiff was not too concerned with this disposition.
The issue on appeal, therefore, was whether the trial court erred in dismissing the complaint with prejudice based on the plaintiff’s failure to file a certificate of good faith with her complaint. A certificate of good faith must be filed in a health care liability action where expert testimony is required. Expert proof is usually required to establish the relevant standard of care. Expert proof will not be required, however, when the claim falls within the “common knowledge” exception. This exception applies when the trier of fact can determine, based on common knowledge, that the direct allegations against a defendant constitute negligence. Plaintiff here claimed this exception applied and argued that she need not file a certificate of good faith.
In answering whether the plaintiff has “made claims of medical negligence that are so obvious and understandable as to be within the common knowledge of a layperson,” the Court reviewed the extensive case law on the issue. In particular, the Court observed a number of cases where a health care provider neglected to restrain a patient in various circumstances and, in each such instance, the Court concluded that expert testimony was required. For instance, the decision of a health care provider as to whether a catatonic patient should be restrained was held to be outside the common knowledge of an ordinary lay person. Tucker v. Metro. Gov’t of Nashville & Davidson Cnty., 686 S.W.2d 87, 93-4 (Tenn. Ct. App. 1984).
Analogizing the facts of this case to many others, the Court concluded that plaintiff’s allegations involve matters that are not within the ordinary knowledge of an ordinary person, as they involve the evaluation and treatment of both the mental and physical capacities of both the attacker and the decedent. In particular, the question of whether and how to restrain or supervise a potentially dangerous mental patient involves knowledge and understanding of his diagnosis and medical history.
Accordingly, the Court of Appeals agreed with the trial court that a certificate of good faith was required pursuant to Tenn. Code Ann. § 29-26-122. Because no certificate of good faith was filed, dismissal with prejudice was the correct result and the trial court was affirmed.
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